Individual
LUIS RENE DELGADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1940 GRAND CONCOURSE, BRONX, NY 10457-5221
(718) 583-6347
(718) 583-8047
Mailing address
5665 KENNEDY BLVD, APT 419, NORTH BERGEN, NJ 07047-3223
(787) 378-9360
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
056374
NY
Other
Enumeration date
09/02/2012
Last updated
11/21/2012
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